|
EAPG 94: CARDIAC REHABILITATION
|
Facility
OP
|
$75.89
|
|
|
Service Code
|
EAPG 0094
|
| Min. Negotiated Rate |
$33.73 |
| Max. Negotiated Rate |
$75.89 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$75.89
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$33.73
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$33.73
|
| Rate for Payer: CDPHP Essential Plan |
$75.89
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$40.48
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$33.73
|
| Rate for Payer: EmblemHealth Medicaid |
$33.73
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$75.89
|
| Rate for Payer: Hamaspik Choice Medicaid |
$33.73
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$33.73
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$72.52
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$72.52
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$33.73
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$35.42
|
|
|
EAPG 95: THROMBOLYSIS
|
Facility
OP
|
$418.68
|
|
|
Service Code
|
EAPG 0095
|
| Min. Negotiated Rate |
$186.08 |
| Max. Negotiated Rate |
$418.68 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$418.68
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$186.08
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$186.08
|
| Rate for Payer: CDPHP Essential Plan |
$418.68
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$223.30
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$186.08
|
| Rate for Payer: EmblemHealth Medicaid |
$186.08
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$418.68
|
| Rate for Payer: Hamaspik Choice Medicaid |
$186.08
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$186.08
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$400.07
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$400.07
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$186.08
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$195.38
|
|
|
EAPG 96: ATRIAL AND VENTRICULAR RECORDING AND PACING
|
Facility
OP
|
$1,069.81
|
|
|
Service Code
|
EAPG 0096
|
| Min. Negotiated Rate |
$475.47 |
| Max. Negotiated Rate |
$1,069.81 |
| Rate for Payer: Hamaspik Choice Medicaid |
$475.47
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$1,069.81
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$475.47
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$475.47
|
| Rate for Payer: CDPHP Essential Plan |
$1,069.81
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$570.56
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$475.47
|
| Rate for Payer: EmblemHealth Medicaid |
$475.47
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$1,069.81
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$475.47
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$1,022.26
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$1,022.26
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$475.47
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$499.24
|
|
|
EAPG 97: AICD AND RELATED CARDIAC DEVICE INSERTION OR REPLACEMENT
|
Facility
OP
|
$29,951.28
|
|
|
Service Code
|
EAPG 0097
|
| Min. Negotiated Rate |
$13,311.68 |
| Max. Negotiated Rate |
$29,951.28 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$29,951.28
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$13,311.68
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$13,311.68
|
| Rate for Payer: CDPHP Essential Plan |
$29,951.28
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$15,974.02
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$13,311.68
|
| Rate for Payer: EmblemHealth Medicaid |
$13,311.68
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$29,951.28
|
| Rate for Payer: Hamaspik Choice Medicaid |
$13,311.68
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$13,311.68
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$28,620.11
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$28,620.11
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$13,311.68
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$13,977.26
|
|
|
EAPG 99: LEVEL I PERCUTANEOUS CORONARY AND INTRACARDIAC INTERVENTIONAL PROCEDURES
|
Facility
OP
|
$5,326.70
|
|
|
Service Code
|
EAPG 0099
|
| Min. Negotiated Rate |
$2,367.42 |
| Max. Negotiated Rate |
$5,326.70 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$5,326.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$2,367.42
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$2,367.42
|
| Rate for Payer: CDPHP Essential Plan |
$5,326.70
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$2,840.90
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$2,367.42
|
| Rate for Payer: EmblemHealth Medicaid |
$2,367.42
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$5,326.70
|
| Rate for Payer: Hamaspik Choice Medicaid |
$2,367.42
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$2,367.42
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$5,089.95
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$5,089.95
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$2,367.42
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$2,485.79
|
|
|
EAPG 9: LEVEL I SKIN EXCISIONS, BIOPSIES, AND REPAIRS
|
Facility
OP
|
$1,256.47
|
|
|
Service Code
|
EAPG 0009
|
| Min. Negotiated Rate |
$558.43 |
| Max. Negotiated Rate |
$1,256.47 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$1,256.47
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$558.43
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$558.43
|
| Rate for Payer: CDPHP Essential Plan |
$1,256.47
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$670.12
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$558.43
|
| Rate for Payer: EmblemHealth Medicaid |
$558.43
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$1,256.47
|
| Rate for Payer: Hamaspik Choice Medicaid |
$558.43
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$558.43
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$1,200.62
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$1,200.62
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$558.43
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$586.35
|
|
|
EASY CAP CO2 DETECTOR
|
Facility
OP
|
$37.00
|
|
| Hospital Charge Code |
4479167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.58 |
| Max. Negotiated Rate |
$29.78 |
| Rate for Payer: Aetna of NY Commercial |
$25.90
|
| Rate for Payer: Aetna of NY Medicare |
$17.02
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$27.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$27.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$13.69
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$18.50
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: CDPHP Commercial |
$29.78
|
| Rate for Payer: CDPHP Medicare |
$13.69
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$29.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$29.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$29.60
|
| Rate for Payer: EmblemHealth Medicaid |
$29.60
|
| Rate for Payer: EmblemHealth Medicare |
$12.58
|
| Rate for Payer: EmblemHealth Select Care |
$26.64
|
| Rate for Payer: Fidelis Medicare |
$14.10
|
| Rate for Payer: Galaxy Health Commercial |
$24.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$13.69
|
| Rate for Payer: Humana Medicare |
$13.69
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$25.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$17.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$27.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.83
|
| Rate for Payer: MVP Health Care of NY Medicare |
$14.37
|
| Rate for Payer: United Healthcare Medicare |
$13.69
|
| Rate for Payer: WellCare Medicare |
$20.35
|
|
|
EBV PROFILE
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
HCPCS 86663
|
| Hospital Charge Code |
4300291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$60.38 |
| Rate for Payer: Aetna of NY Commercial |
$48.75
|
| Rate for Payer: Aetna of NY Medicare |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$56.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$56.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$27.75
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$37.50
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: CDPHP Commercial |
$60.38
|
| Rate for Payer: CDPHP Medicare |
$27.75
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$60.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$60.00
|
| Rate for Payer: EmblemHealth Medicaid |
$60.00
|
| Rate for Payer: EmblemHealth Medicare |
$25.50
|
| Rate for Payer: Fidelis Medicare |
$28.58
|
| Rate for Payer: Galaxy Health Commercial |
$48.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$27.75
|
| Rate for Payer: Humana Medicare |
$27.75
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$48.75
|
| Rate for Payer: Local 1199SEIU Medicare |
$34.50
|
| Rate for Payer: MVP Health Care of NY Commercial |
$56.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$42.22
|
| Rate for Payer: MVP Health Care of NY Medicare |
$29.14
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$56.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$13.12
|
| Rate for Payer: United Healthcare Commercial |
$56.25
|
| Rate for Payer: United Healthcare Medicare |
$27.75
|
| Rate for Payer: WellCare Medicare |
$41.25
|
|
|
ECG/MONITORING AND ANALYSIS
|
Facility
OP
|
$277.00
|
|
|
Service Code
|
HCPCS 93271
|
| Hospital Charge Code |
4480042
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$222.98 |
| Rate for Payer: Aetna of NY Commercial |
$180.05
|
| Rate for Payer: Aetna of NY Medicare |
$127.42
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$207.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$207.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$102.49
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$138.50
|
| Rate for Payer: Cash Price |
$207.75
|
| Rate for Payer: Cash Price |
$207.75
|
| Rate for Payer: CDPHP Commercial |
$222.98
|
| Rate for Payer: CDPHP Medicare |
$102.49
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$221.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$221.60
|
| Rate for Payer: EmblemHealth Medicaid |
$221.60
|
| Rate for Payer: EmblemHealth Medicare |
$94.18
|
| Rate for Payer: Fidelis Medicare |
$105.56
|
| Rate for Payer: Galaxy Health Commercial |
$180.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$102.49
|
| Rate for Payer: Humana Medicare |
$102.49
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$180.05
|
| Rate for Payer: Local 1199SEIU Medicare |
$127.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$207.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$155.95
|
| Rate for Payer: MVP Health Care of NY Medicare |
$107.61
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$9.09
|
| Rate for Payer: United Healthcare Medicare |
$102.49
|
| Rate for Payer: WellCare Medicare |
$152.35
|
|
|
ECHOBRIGHT 20GX100MM NEEDLE
|
Facility
OP
|
$59.00
|
|
| Hospital Charge Code |
4479211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.06 |
| Max. Negotiated Rate |
$47.50 |
| Rate for Payer: Aetna of NY Commercial |
$41.30
|
| Rate for Payer: Aetna of NY Medicare |
$27.14
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$44.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$44.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.83
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$29.50
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: CDPHP Commercial |
$47.50
|
| Rate for Payer: CDPHP Medicare |
$21.83
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$47.20
|
| Rate for Payer: EmblemHealth Medicaid |
$47.20
|
| Rate for Payer: EmblemHealth Medicare |
$20.06
|
| Rate for Payer: EmblemHealth Select Care |
$42.48
|
| Rate for Payer: Fidelis Medicare |
$22.48
|
| Rate for Payer: Galaxy Health Commercial |
$38.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.83
|
| Rate for Payer: Humana Medicare |
$21.83
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$41.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$27.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$44.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$33.22
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.92
|
| Rate for Payer: United Healthcare Medicare |
$21.83
|
| Rate for Payer: WellCare Medicare |
$32.45
|
|
|
ECHOBRIGHT 20GX1501MM NEEDLE
|
Facility
OP
|
$59.00
|
|
| Hospital Charge Code |
4479212
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.06 |
| Max. Negotiated Rate |
$47.50 |
| Rate for Payer: Aetna of NY Commercial |
$41.30
|
| Rate for Payer: Aetna of NY Medicare |
$27.14
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$44.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$44.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.83
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$29.50
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: CDPHP Commercial |
$47.50
|
| Rate for Payer: CDPHP Medicare |
$21.83
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$47.20
|
| Rate for Payer: EmblemHealth Medicaid |
$47.20
|
| Rate for Payer: EmblemHealth Medicare |
$20.06
|
| Rate for Payer: EmblemHealth Select Care |
$42.48
|
| Rate for Payer: Fidelis Medicare |
$22.48
|
| Rate for Payer: Galaxy Health Commercial |
$38.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.83
|
| Rate for Payer: Humana Medicare |
$21.83
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$41.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$27.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$44.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$33.22
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.92
|
| Rate for Payer: United Healthcare Medicare |
$21.83
|
| Rate for Payer: WellCare Medicare |
$32.45
|
|
|
ECHOBRIGHT 22GX50MM NEEDLE
|
Facility
OP
|
$59.00
|
|
| Hospital Charge Code |
4479210
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.06 |
| Max. Negotiated Rate |
$47.50 |
| Rate for Payer: Aetna of NY Commercial |
$41.30
|
| Rate for Payer: Aetna of NY Medicare |
$27.14
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$44.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$44.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.83
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$29.50
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: CDPHP Commercial |
$47.50
|
| Rate for Payer: CDPHP Medicare |
$21.83
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$47.20
|
| Rate for Payer: EmblemHealth Medicaid |
$47.20
|
| Rate for Payer: EmblemHealth Medicare |
$20.06
|
| Rate for Payer: EmblemHealth Select Care |
$42.48
|
| Rate for Payer: Fidelis Medicare |
$22.48
|
| Rate for Payer: Galaxy Health Commercial |
$38.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.83
|
| Rate for Payer: Humana Medicare |
$21.83
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$41.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$27.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$44.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$33.22
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.92
|
| Rate for Payer: United Healthcare Medicare |
$21.83
|
| Rate for Payer: WellCare Medicare |
$32.45
|
|
|
ECHOCARDIOGRAPHY, TRANSTHORACIC FOLLOW-UP OR LIMITED STUDY
|
Facility
OP
|
$701.00
|
|
|
Service Code
|
HCPCS 93308
|
| Hospital Charge Code |
4480107
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$60.60 |
| Max. Negotiated Rate |
$564.30 |
| Rate for Payer: Aetna of NY Commercial |
$455.65
|
| Rate for Payer: Aetna of NY Medicare |
$322.46
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$525.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$525.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$259.37
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$350.50
|
| Rate for Payer: Cash Price |
$525.75
|
| Rate for Payer: Cash Price |
$525.75
|
| Rate for Payer: CDPHP Commercial |
$564.30
|
| Rate for Payer: CDPHP Medicare |
$259.37
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$560.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$560.80
|
| Rate for Payer: EmblemHealth Medicaid |
$560.80
|
| Rate for Payer: EmblemHealth Medicare |
$238.34
|
| Rate for Payer: Fidelis Medicare |
$267.15
|
| Rate for Payer: Galaxy Health Commercial |
$455.65
|
| Rate for Payer: Hamaspik Choice Medicare |
$259.37
|
| Rate for Payer: Humana Medicare |
$259.37
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$455.65
|
| Rate for Payer: Local 1199SEIU Medicare |
$322.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$525.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$394.66
|
| Rate for Payer: MVP Health Care of NY Medicare |
$272.34
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$525.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$60.60
|
| Rate for Payer: United Healthcare Commercial |
$525.75
|
| Rate for Payer: United Healthcare Medicare |
$259.37
|
| Rate for Payer: WellCare Medicare |
$385.55
|
|
|
ECHOLONG 18GX100MM NEEDLE
|
Facility
OP
|
$137.00
|
|
| Hospital Charge Code |
4479214
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.58 |
| Max. Negotiated Rate |
$110.28 |
| Rate for Payer: Aetna of NY Commercial |
$95.90
|
| Rate for Payer: Aetna of NY Medicare |
$63.02
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$102.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$102.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$50.69
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$68.50
|
| Rate for Payer: Cash Price |
$102.75
|
| Rate for Payer: CDPHP Commercial |
$110.28
|
| Rate for Payer: CDPHP Medicare |
$50.69
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$109.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$109.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$109.60
|
| Rate for Payer: EmblemHealth Medicaid |
$109.60
|
| Rate for Payer: EmblemHealth Medicare |
$46.58
|
| Rate for Payer: EmblemHealth Select Care |
$98.64
|
| Rate for Payer: Fidelis Medicare |
$52.21
|
| Rate for Payer: Galaxy Health Commercial |
$89.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$50.69
|
| Rate for Payer: Humana Medicare |
$50.69
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$95.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$63.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$102.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$77.13
|
| Rate for Payer: MVP Health Care of NY Medicare |
$53.22
|
| Rate for Payer: United Healthcare Medicare |
$50.69
|
| Rate for Payer: WellCare Medicare |
$75.35
|
|
|
ECHOLONG 18GX150MM NEEDLE
|
Facility
OP
|
$160.00
|
|
| Hospital Charge Code |
4479215
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.40 |
| Max. Negotiated Rate |
$128.80 |
| Rate for Payer: Aetna of NY Commercial |
$112.00
|
| Rate for Payer: Aetna of NY Medicare |
$73.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$120.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$120.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$59.20
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$80.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: CDPHP Commercial |
$128.80
|
| Rate for Payer: CDPHP Medicare |
$59.20
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$128.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$128.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$128.00
|
| Rate for Payer: EmblemHealth Medicaid |
$128.00
|
| Rate for Payer: EmblemHealth Medicare |
$54.40
|
| Rate for Payer: EmblemHealth Select Care |
$115.20
|
| Rate for Payer: Fidelis Medicare |
$60.98
|
| Rate for Payer: Galaxy Health Commercial |
$104.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$59.20
|
| Rate for Payer: Humana Medicare |
$59.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$73.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$90.08
|
| Rate for Payer: MVP Health Care of NY Medicare |
$62.16
|
| Rate for Payer: United Healthcare Medicare |
$59.20
|
| Rate for Payer: WellCare Medicare |
$88.00
|
|
|
ECHOLONG 18GX50MM NEEDLE
|
Facility
OP
|
$137.00
|
|
| Hospital Charge Code |
4479213
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.58 |
| Max. Negotiated Rate |
$110.28 |
| Rate for Payer: Aetna of NY Commercial |
$95.90
|
| Rate for Payer: Aetna of NY Medicare |
$63.02
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$102.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$102.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$50.69
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$68.50
|
| Rate for Payer: Cash Price |
$102.75
|
| Rate for Payer: CDPHP Commercial |
$110.28
|
| Rate for Payer: CDPHP Medicare |
$50.69
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$109.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$109.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$109.60
|
| Rate for Payer: EmblemHealth Medicaid |
$109.60
|
| Rate for Payer: EmblemHealth Medicare |
$46.58
|
| Rate for Payer: EmblemHealth Select Care |
$98.64
|
| Rate for Payer: Fidelis Medicare |
$52.21
|
| Rate for Payer: Galaxy Health Commercial |
$89.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$50.69
|
| Rate for Payer: Humana Medicare |
$50.69
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$95.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$63.02
|
| Rate for Payer: MVP Health Care of NY Commercial |
$102.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$77.13
|
| Rate for Payer: MVP Health Care of NY Medicare |
$53.22
|
| Rate for Payer: United Healthcare Medicare |
$50.69
|
| Rate for Payer: WellCare Medicare |
$75.35
|
|
|
ECHO TRANSESOPHAGEAL
|
Facility
OP
|
$1,579.00
|
|
|
Service Code
|
HCPCS 93312
|
| Hospital Charge Code |
4201042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$106.05 |
| Max. Negotiated Rate |
$1,271.10 |
| Rate for Payer: Aetna of NY Commercial |
$1,026.35
|
| Rate for Payer: Aetna of NY Medicare |
$726.34
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,184.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,184.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$584.23
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$789.50
|
| Rate for Payer: Cash Price |
$1,184.25
|
| Rate for Payer: Cash Price |
$1,184.25
|
| Rate for Payer: CDPHP Commercial |
$1,271.10
|
| Rate for Payer: CDPHP Medicare |
$584.23
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,263.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,263.20
|
| Rate for Payer: EmblemHealth Medicaid |
$1,263.20
|
| Rate for Payer: EmblemHealth Medicare |
$536.86
|
| Rate for Payer: Fidelis Medicare |
$601.76
|
| Rate for Payer: Galaxy Health Commercial |
$1,026.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$584.23
|
| Rate for Payer: Humana Medicare |
$584.23
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,026.35
|
| Rate for Payer: Local 1199SEIU Medicare |
$726.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,184.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$888.98
|
| Rate for Payer: MVP Health Care of NY Medicare |
$613.44
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$475.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$106.05
|
| Rate for Payer: United Healthcare Commercial |
$475.00
|
| Rate for Payer: United Healthcare Medicare |
$584.23
|
| Rate for Payer: WellCare Medicare |
$868.45
|
|
|
ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D
|
Facility
OP
|
$1,579.00
|
|
|
Service Code
|
HCPCS 93306 TC
|
| Hospital Charge Code |
4480087
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$536.86 |
| Max. Negotiated Rate |
$1,271.10 |
| Rate for Payer: Aetna of NY Medicare |
$726.34
|
| Rate for Payer: Aetna of NY Commercial |
$1,026.35
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,184.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,184.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$584.23
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$789.50
|
| Rate for Payer: Cash Price |
$1,184.25
|
| Rate for Payer: CDPHP Commercial |
$1,271.10
|
| Rate for Payer: CDPHP Medicare |
$584.23
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,263.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,263.20
|
| Rate for Payer: EmblemHealth Medicaid |
$1,263.20
|
| Rate for Payer: EmblemHealth Medicare |
$536.86
|
| Rate for Payer: Fidelis Medicare |
$601.76
|
| Rate for Payer: Galaxy Health Commercial |
$1,026.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$584.23
|
| Rate for Payer: Humana Medicare |
$584.23
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,026.35
|
| Rate for Payer: Local 1199SEIU Medicare |
$726.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,184.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$888.98
|
| Rate for Payer: MVP Health Care of NY Medicare |
$613.44
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,184.25
|
| Rate for Payer: United Healthcare Commercial |
$1,184.25
|
| Rate for Payer: United Healthcare Medicare |
$584.23
|
| Rate for Payer: WellCare Medicare |
$868.45
|
|
|
ECONOMY COTTON STOCKINETTE 5"
|
Facility
OP
|
$13.00
|
|
| Hospital Charge Code |
4471422
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$10.46 |
| Rate for Payer: Aetna of NY Commercial |
$9.10
|
| Rate for Payer: Aetna of NY Medicare |
$5.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$9.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$9.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.81
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$6.50
|
| Rate for Payer: Cash Price |
$9.75
|
| Rate for Payer: CDPHP Commercial |
$10.46
|
| Rate for Payer: CDPHP Medicare |
$4.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$10.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$10.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$10.40
|
| Rate for Payer: EmblemHealth Medicaid |
$10.40
|
| Rate for Payer: EmblemHealth Medicare |
$4.42
|
| Rate for Payer: EmblemHealth Select Care |
$9.36
|
| Rate for Payer: Fidelis Medicare |
$4.95
|
| Rate for Payer: Galaxy Health Commercial |
$8.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.81
|
| Rate for Payer: Humana Medicare |
$4.81
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$9.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$7.32
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.05
|
| Rate for Payer: United Healthcare Medicare |
$4.81
|
| Rate for Payer: WellCare Medicare |
$7.15
|
|
|
ECUP TEST
|
Facility
OP
|
$58.00
|
|
| Hospital Charge Code |
4304882
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.72 |
| Max. Negotiated Rate |
$46.69 |
| Rate for Payer: Aetna of NY Commercial |
$40.60
|
| Rate for Payer: Aetna of NY Medicare |
$26.68
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.46
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$29.00
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: CDPHP Commercial |
$46.69
|
| Rate for Payer: CDPHP Medicare |
$21.46
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$46.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$46.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$46.40
|
| Rate for Payer: EmblemHealth Medicaid |
$46.40
|
| Rate for Payer: EmblemHealth Medicare |
$19.72
|
| Rate for Payer: EmblemHealth Select Care |
$41.76
|
| Rate for Payer: Fidelis Medicare |
$22.10
|
| Rate for Payer: Galaxy Health Commercial |
$37.70
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.46
|
| Rate for Payer: Humana Medicare |
$21.46
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$40.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$26.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$43.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$32.65
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.53
|
| Rate for Payer: United Healthcare Medicare |
$21.46
|
| Rate for Payer: WellCare Medicare |
$31.90
|
|
|
EKG 12 LEAD; TRACING ONLY
|
Facility
OP
|
$195.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
4480086
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$156.98 |
| Rate for Payer: Aetna of NY Commercial |
$126.75
|
| Rate for Payer: Aetna of NY Medicare |
$89.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$146.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$146.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$72.15
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$97.50
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: CDPHP Commercial |
$156.98
|
| Rate for Payer: CDPHP Medicare |
$72.15
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$156.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$156.00
|
| Rate for Payer: EmblemHealth Medicaid |
$156.00
|
| Rate for Payer: EmblemHealth Medicare |
$66.30
|
| Rate for Payer: Fidelis Medicare |
$74.31
|
| Rate for Payer: Galaxy Health Commercial |
$126.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$72.15
|
| Rate for Payer: Humana Medicare |
$72.15
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$126.75
|
| Rate for Payer: Local 1199SEIU Medicare |
$89.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$146.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$109.78
|
| Rate for Payer: MVP Health Care of NY Medicare |
$75.76
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$7.58
|
| Rate for Payer: United Healthcare Medicare |
$72.15
|
| Rate for Payer: WellCare Medicare |
$107.25
|
|
|
EKG 12 LEAD; TRACING ONLY
|
Facility
OP
|
$175.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
4480013
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$140.88 |
| Rate for Payer: Aetna of NY Commercial |
$113.75
|
| Rate for Payer: Aetna of NY Medicare |
$80.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$131.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$131.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$64.75
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$87.50
|
| Rate for Payer: Cash Price |
$131.25
|
| Rate for Payer: Cash Price |
$131.25
|
| Rate for Payer: CDPHP Commercial |
$140.88
|
| Rate for Payer: CDPHP Medicare |
$64.75
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$140.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$140.00
|
| Rate for Payer: EmblemHealth Medicaid |
$140.00
|
| Rate for Payer: EmblemHealth Medicare |
$59.50
|
| Rate for Payer: Fidelis Medicare |
$66.69
|
| Rate for Payer: Galaxy Health Commercial |
$113.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$64.75
|
| Rate for Payer: Humana Medicare |
$64.75
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$113.75
|
| Rate for Payer: Local 1199SEIU Medicare |
$80.50
|
| Rate for Payer: MVP Health Care of NY Commercial |
$131.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$98.52
|
| Rate for Payer: MVP Health Care of NY Medicare |
$67.99
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$7.58
|
| Rate for Payer: United Healthcare Medicare |
$64.75
|
| Rate for Payer: WellCare Medicare |
$96.25
|
|
|
ELBOW ORTHOTIC (EO), WITHOUT JOINTS, CUSTOM FABRICATED
|
Facility
OP
|
$802.00
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
4690162
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$272.68 |
| Max. Negotiated Rate |
$645.61 |
| Rate for Payer: Aetna of NY Commercial |
$561.40
|
| Rate for Payer: Aetna of NY Medicare |
$368.92
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$360.90
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$360.90
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$296.74
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$401.00
|
| Rate for Payer: Cash Price |
$601.50
|
| Rate for Payer: Cash Price |
$601.50
|
| Rate for Payer: CDPHP Commercial |
$645.61
|
| Rate for Payer: CDPHP Medicare |
$296.74
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$401.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$641.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$641.60
|
| Rate for Payer: EmblemHealth Medicaid |
$641.60
|
| Rate for Payer: EmblemHealth Medicare |
$272.68
|
| Rate for Payer: EmblemHealth Select Care |
$401.00
|
| Rate for Payer: Fidelis Medicare |
$305.64
|
| Rate for Payer: Galaxy Health Commercial |
$521.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$296.74
|
| Rate for Payer: Humana Medicare |
$296.74
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$561.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$368.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$601.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$451.53
|
| Rate for Payer: MVP Health Care of NY Medicare |
$311.58
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$281.03
|
| Rate for Payer: United Healthcare Medicare |
$296.74
|
| Rate for Payer: WellCare Medicare |
$441.10
|
|
|
ELECTRICAL STIMULATION EA 15 MINS
|
Facility
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 97032 GP
|
| Hospital Charge Code |
4650080
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna of NY Commercial |
$112.00
|
| Rate for Payer: Aetna of NY Medicare |
$23.92
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$39.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$39.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$19.24
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$108.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: CDPHP Commercial |
$41.86
|
| Rate for Payer: CDPHP Medicare |
$19.24
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$41.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$41.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$41.60
|
| Rate for Payer: EmblemHealth Medicaid |
$41.60
|
| Rate for Payer: EmblemHealth Medicare |
$17.68
|
| Rate for Payer: EmblemHealth Select Care |
$37.44
|
| Rate for Payer: Fidelis Medicare |
$19.82
|
| Rate for Payer: Galaxy Health Commercial |
$33.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$19.24
|
| Rate for Payer: Humana Medicare |
$19.24
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$23.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$134.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$20.20
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$156.00
|
| Rate for Payer: United Healthcare Commercial |
$156.00
|
| Rate for Payer: United Healthcare Medicare |
$19.24
|
| Rate for Payer: WellCare Medicare |
$28.60
|
|
|
ELECTRICAL STIMULATION EA 15 MINS (MOD 59)
|
Facility
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 97032 GP,59
|
| Hospital Charge Code |
4650395
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna of NY Commercial |
$112.00
|
| Rate for Payer: Aetna of NY Medicare |
$23.92
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$39.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$39.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$19.24
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$108.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: CDPHP Commercial |
$41.86
|
| Rate for Payer: CDPHP Medicare |
$19.24
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$41.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$41.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$41.60
|
| Rate for Payer: EmblemHealth Medicaid |
$41.60
|
| Rate for Payer: EmblemHealth Medicare |
$17.68
|
| Rate for Payer: EmblemHealth Select Care |
$37.44
|
| Rate for Payer: Fidelis Medicare |
$19.82
|
| Rate for Payer: Galaxy Health Commercial |
$33.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$19.24
|
| Rate for Payer: Humana Medicare |
$19.24
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$23.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$179.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$134.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$20.20
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$156.00
|
| Rate for Payer: United Healthcare Commercial |
$156.00
|
| Rate for Payer: United Healthcare Medicare |
$19.24
|
| Rate for Payer: WellCare Medicare |
$28.60
|
|
